I can't say that we (In Albuquerque, New Mexico, US) have it figured out. But what has worked with me has been to be part of social movements outside of work and to pull in movement people to PH projects. Also, when working with community people I point out the health connections to their issues. It is very difficult as even many of the people who talk SDoH default back to a program or increasing services. 

I am working on promoting SDoH all day long. The hardest part is getting a clinic to be SDoH advocates - so any good examples of that would help out. I also became the SDoH rep. for the NM Public Health Association in charge of trying to keep that in every conversation of the board. 

We are a long way from doing well, but there are those who are trying. We just need to share successes so we can learn from each other. If I do well we will have health explicitly mentioned in a Sector Plan (neighborhood level urban planning document). Wish me luck!

Atentamente,

Enrique Cardiel 
Urban Health Extension Coordinator 
505-925-7393 
"Social determinants of health are life-enhancing resources, such as food supply, housing, economic and social relationships, transportation, education, and health care, whose distribution across populations effectively determines length and quality of life.” - CDC




-----Original Message-----
From: Social Determinants of Health on behalf of Gayle Thoun
Sent: Tue 6/1/2010 2:41 PM
To: [log in to unmask]
Subject: Re: [SDOH] and now for something absolutely underwhelming...
 
IMHO the other thing that PH can do is keeping spreading the word and educating communities and their residents about what really influences their health - not more hospitals and doctors which they solely lobby for.  You are right about much of the SDOHs being outside of the mandate of PH - at least at the front lines where I am.  If we can get communities and residents to understand the SDOHs and then advocate for those, we may see progress.  I love the end of the DVD "Unnatural Causes" where Dr. Troutman celebrates with the community in the opening of the "Centre for Health Equity" where RESIDENTS will gain capacity to advocate for the SDOH on their own behalf.   (I wonder how that Centre is doing.)  That DVD has been so invaluable in my work in helping people to see what Health Promotion really looks like and what really makes them healthy.

But ultimately 24 years is a long time and it's still all talk.....


Gayle Thoun, Community Health Facilitator, BScN., R.N.

Alberta Health Services, Public Health

Stettler Community Health Services

5911 - 50th Ave.,

Stettler, Alberta T0C 2L0

403-740-8104

[log in to unmask]<mailto:[log in to unmask]>

________________________________
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of Lyne Cantin
Sent: Tuesday, June 01, 2010 7:47 AM
Subject: Re: and now for something absolutely underwhelming...

It is sad to say but in my observation and humble opinion, Public Health is struggling to grasp the Social determinants of Health.  Public Health is unfortunately still trying to "integrate" social determinants in their programming and to find its role, when it is clear that the root causes "the Social issues" impacting health are outside of the PH's realm.  The only meaningful role that PH can play is to advocate for development of new social policies to create supportive environment and communitites - education, employment, housing and food security, social integration.    Public Health Associations could be a powerful lobby group if they took a leadership role in advocating at all level of governments.

LC

________________________________
From: Social Determinants of Health [mailto:[log in to unmask]] On Behalf Of Dennis Raphael
Sent: June 1, 2010 1:47 AM
To: [log in to unmask]
Subject: Re: [SDOH] and now for something absolutely underwhelming...

There is a clear implication that the characters in the vignette brought on their diseases on themselves by using vending machines, driving to school, playing video games, and eating macaroni and cheese.

To DISTORT  Dr Troutman's quote from Unnatural Causes:

"If only we just ate more fruits and vegetables and exercised more, everything would be all right."

As my students pointed out in class yesterday, chronic diseases such as CVD and type II diabetes are brought on by material and social deprivation during childhood and adulthood, crappy working conditions and employment insecurity, social exclusion, and stress associated with financial, housing, and food insecurity.  This document also implies that poverty is bad because it prevents vegetables and fruits from entering people's mouths.

This is the flagship public health organization in the province .  What message does it convey to medical officers of health, board members, and public health workers?

It also is factually untrue. Everything would not be hunky-dory if people stuffed their faces with fruits and vegetables. The references to poverty and exclusion are throwaway lines -- let's provides some platitudes about poverty, The public policy references within the document are vapid.

This document is coming from the nation that introduced the Ottawa Charter in 1986 -- for G-d's sake..  That's 24 years for these ideas to sink into public health thinking!

dr


Dennis Raphael, PhD
Professor of Health Policy and Management
York University
4700 Keele Street
Room 418, HNES Building
Toronto, Ontario M3J 1P3
416-736-2100, ext. 22134
email: [log in to unmask]
http://www.atkinson.yorku.ca/draphael

Of interest:

* NEW * Health Promotion and Quality of Life in Canada: Essential Readings, edited by Dennis Raphael
<http://www.atkinson.yorku.ca/draphael>http://tinyurl.com/ycb4rm5

Social Determinants of Health: Canadian Perspectives, 2nd edition, edited by Dennis Raphael
Forewords by Carolyn Bennett and Roy Romanow
<http://tinyurl.com/ycb4rm5>http://tinyurl.com/5l6yh9

Poverty and Policy in Canada: Implications for Health and Quality of Life by Dennis Raphael
Foreword by Jack Layton
<http://tinyurl.com/5l6yh9>http://tinyurl.com/2hg2df

* NEW * Staying Alive: Critical Perspectives on Health, Illness, and Health Care, 2nd edition
edited by Toba Bryant, Dennis Raphael, and Marcia Rioux
Foreword by Gary Teeple
<http://tinyurl.com/2hg2df>http://tinyurl.com/yehawne

See a lecture!  The Politics of Population Health
<http://tinyurl.com/yehawne>http://msl.stream.yorku.ca/mediasite/viewer/?peid=ac604170-9ccc-4268-a1af-9a9e04b28e1d

Also, presentation on Politics and Health at the Centre for Health Disparities in Cleveland Ohio
<http://msl.stream.yorku.ca/mediasite/viewer/?peid=ac604170-9ccc-4268-a1af-9a9e04b28e1d>http://www.case.edu/med/ccrhd/education

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